MEDICARE: CMU

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124517768
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CMU

Provider Business Mailing Address
First Line	:	1100 S CAMERON ST STE 1
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17104-2547
Country	:	US
Telephone Number	:	717-441-7033
Fax Number	:	717-232-9350

Provider Business Practice Location Address
First Line	:	1349 CUMBERLAND ST
Second Line	:
City	:	LEBANON
State	:	PA
Zip	:	17042-4504
Country	:	US
Telephone Number	:	717-644-9600
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	MR. MARK A VERANO
Credential	:
Telephone Number	:	717-441-7033

Provider Enumeration Date	:	05/09/2018
Last Update Date	:	05/24/2018

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Directions to “CMU ” Practice Location

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